Clinical outcomes of T-cell-mediated rejection in renal allografts

Abstract

Background: T-cell-mediated rejection (TCMR) occurs in 10%–12% of renal allografts. TCMR manifests as a rise in serum creatinine, decreased urine output, fever, and graft tenderness. It has a negative impact on long-term allograft function. Hence, we did a retrospective analysis of patients with TCMR to know the pattern, risk factors, and treatment outcome. Materials and Methods: We analyzed retrospectively clinical characteristics, laboratory data, renal biopsy reports, precipitating factors, treatment modalities, and outcomes from case records and biopsy registers of 30 patients with TCMR between July 2019 and June 2021 in our institution. Results: Out of 30 patients studied, 80% were males and 20% were females. The mean age was 29.67 ± 8.8 years. Live-related renal transplantation accounted for 80% of patients. Native kidney disease was not known in 63%. The mean duration of rejection was 21.73 ± 23.24 months. Among the various risk factors studied, low tacrolimus levels were seen in 56.7%, which was statistically significant (P < 0.05). All the patients were treated for rejection, and improvement was seen in most and 10.7% showed no improvement. Conclusion: Most patients with TCMR improved with treatment. Inadequate immunosuppression was the risk factor for TCMR in the maximum number of our patients. Compliance was good in most patients.

Keywords

• allograft
• renal transplantation
• tacrolimus
• t-cell-mediated rejection